Hodgkin's Disease and Chemotherapy

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Dear OncoLink "Ask the Experts,"
My husband was recently diagnosed with lymphocyte predominant Hodgkin's Disease (nodular type) and is presently undergoing ABVD chemotherapy treatment prior to radiation therapy. In trying to learn as much as possible about this I am wading through some confusing information. Please send information on prognosis and symptoms.

Dear RP: Hodgkin's Disease (HD) is one of the two major types of lymphoma, or malignancy of the lymphatic system. Patients most often seek medical attention for enlarged lymph nodes, typically in the chest or neck. The treatment for HD is based the histology (appearance under the microscope) and stage of disease. Symptoms of HD are related to the enlarged lymph nodes, as well as the presence of fevers, weight loss, or night sweats ("B" symptoms). The histologic classification of HD has undergone major revisions over the past several years, as the clinical and molecular characteristics of this disease have become better understood. Lymphocyte predominance HD is one of the four major types; however, many oncologists place the nodular type (NLPHD) in a separate category of HD.

The treatment for HD usually involves some combination of chemotherapy often followed by radiation therapy. The ideal combination of chemotherapy continues to be studied; however, "ABVD," "MOPP," "BCVPP," and "MOPP/ABV" are common regimens. In selected early stage patients, the use of radiation therapy alone may be curative. The administration and dose of radiation therapy is often individualized based on location and extent of disease. Because you have not provided staging information, it is difficult to offer prognostic information. Survival with HD has improved dramatically over the past 40 years, and over 90% of early stage patients are cured. Even in advanced stage disease, the majority of patients can be alive in long-term followup. NLPHD typically presents with early stage disease, and responds well to treatment. The NLPHD subtype is unusual in that rarely, patients may develop a non-Hodgkin's lymphoma several years in the future.

Dec 7, 2010 - Rituximab may be a better option than watchful waiting in some lymphoma patients, and a new treatment option appears effective for relapsed or refractory Hodgkin's lymphoma, according to two studies being presented at the annual meeting of the American Society of Hematology, held from Dec. 4 to 7 in Orlando, Fla. Other research being presented will highlight new options for the standard treatment of advanced asymptomatic follicular lymphoma; mantle cell lymphoma; and early, unfavorable Hodgkin's disease.